| Leon Psychiatric Services Pllc | |
|
3101 S Austin Ave Georgetown TX 78626-7541 | |
| (877) 500-9151 | |
| Not Available |
| Full Name | Leon Psychiatric Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3101 S Austin Ave, Georgetown, Texas |
| Authorized Official Name and Position | Phillip J. Leon (OWNER) |
| Authorized Official Contact | 8775009151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leon Psychiatric Services Pllc 513 Sheepshank Dr Georgetown TX 78633-2098 Ph: (918) 557-3542 | Leon Psychiatric Services Pllc 3101 S Austin Ave Georgetown TX 78626-7541 Ph: (877) 500-9151 |
| NPI Number | 1265904817 |
|---|---|
| Provider Enumeration Date | 12/20/2018 |
| Last Update Date | 05/16/2022 |
| Certification Date | 05/16/2022 |
| Medicare PECOS PAC ID | 1456699289 |
|---|---|
| Medicare Enrollment ID | O20190220001953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265904817 | NPI | - | NPPES |
| Q8283 | Other | TX | TEXAS MEDICAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Phillip J Leon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023069853 PECOS PAC ID: 6608827068 Enrollment ID: I20160824001470 |
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